Do You Have a Social Anxiety Disorder?

Avoiding jobs that require you to give a lot of presentations is no big deal — everyone does it, right? And skipping dinners with groups of friends because you get nervous eating around other people is normal, isn’t it?

Actually, avoiding parties, friends, meetings, and other social situations because you get too anxious about them is a big deal. It’s a coping mechanism for an anxiety disorder called social anxiety disorder.

Social Anxiety Disorder: Signs and Symptoms

Social anxiety disorder is very common, affecting around 15 million adults in the United States, and its symptoms can be more subtle than you might think.

“It’s one that is often not detected by patient or doctor. People devise their lives unconsciously and consciously so as to not recognize the presence of the disorder,” says Charles Goodstein, MD, a clinical professor of psychiatry at New York University Langone Medical Center.

“But for some people like that, it becomes an important limitation as opposed to having some sort of clear-cut malfunction. They’ve somehow sidestepped what the real problem is. What we see is a defense against the anxiety rather than the anxiety itself,” says Dr. Goodstein.

Social situations can certainly be nerve-racking, but most people just deal with the temporary discomfort and anxiety because they enjoy other aspects of the interactions. But not everyone can set their anxiety aside.

People with social anxiety disorder feel an overwhelming level of anxiety as well as self-consciousness in certain or even all social settings; they are often convinced that all eyes are on them, watching and waiting for them to make a mistake. Their anxiety about an upcoming event can start weeks in advance. Like certain other forms of anxiety disorder, physical symptoms can show up as well. In addition to sweating, they may experience nausea, difficulty talking, and blushing.

“A social situation always carries risk to some extent when the situation involves people that you don’t know, groups around you that you can’t scan adequately. Most people make an adaptation to it, more or less,” says Goodstein. But for people with social anxiety disorder, it’s terrifying to think about being in a situation for which they can’t prepare or any unknown where they can’t gauge what their response will be, according to Goodstein.

“The anxiety level rises tremendously, and very often you hear that in the middle of giving a talk, for instance, they feel they have to walk off stage. They may feel palpitations or feel that they are going to sweat — and that this is something they have to avoid,” says Goodstein. For people with social anxiety disorder, avoiding the situation seems the sensible thing to do, rather than run the risk of embarrassment.

Social Anxiety Disorder: Causes, Diagnosis, and Treatment

The causes of social anxiety disorder aren’t well understood. Being extremely protected throughout childhood and adolescence may be related to some cases. Social anxiety disorder may be caused by genetics. It often occurs in conjunction with other anxiety disorders and depression, and often results insubstance abuse.

To diagnose social anxiety disorder, a doctor will evaluate your symptoms and situations in which the anxiety occurs. He will also look for physical symptoms of social anxiety disorder, including increased heart rate and blood pressure levels.

Social anxiety disorder can be treated using therapy to help confront fears, first mentally and eventually physically in real circumstances. Antidepressant and anti-anxiety medications may also be given to help manage social anxiety disorder.

Social anxiety disorder is common, but just because you find yourself a little shy or nervous sometimes doesn’t mean that you have the condition. However, if you start avoiding certain situations, and find that your anxiety is really affecting how you live and function, you can learn to manage your social anxiety disorder and regain control over your life.